A catheter-based intervention involves the insertion of a catheter into the vascular system for diagnostic or therapeutic treatment. The intervention often involves the insertion of a guidewire through a blood vessel. The guidewire is inserted and manipulated with the aid of a torque device that is removably attached to the guidewire.
Maintaining accurate control and placement of a guidewire during a medical interventional procedure is essential. Present torque devices used to accomplish this task require excessive manipulation with more than one hand or excessive force parallel to the guide wire axis in order to correctly position the device. This can divert the attention of the interventionalist during the procedure and increase the chance of unwanted movement of the wire in the patient, which could lead to complications.
Most current torque devices require the interventionalist to release the guidewire to reposition the device. These moments of release of the guidewire could result in unexpected advancement or retraction of the guidewire that could lead to problems during the procedure. The guidewire may even be pulled out of the treatment vessel altogether. Movement of the guidewire may result in longer procedures for the patient and the interventionalist, and may cause serious internal harm such as damage to the treatment vessel or abrupt vessel closure.
Existing devices require an interventionalist to perform the following steps to introduce a guidewire to a catheter: (1) insert an introducer through an adaptor coupled to the catheter, such as a Tuohy-Borst adaptor; (2) insert the guidewire through the introducer and into the catheter; (3) remove the introducer from the adaptor while leaving the guidewire in place; and (4) attach a compression torque device to the guidewire for manipulating the guidewire through the catheter. This process requires the interventionalist to release and reposition the various components during the procedure, which increases the possibility of unwanted movement of the introducer, adaptor and guidewire.
An improved compression torque device that may be operated using only one-handed blind operation is described in U.S. Pat. No. 9,375,553 to Freddy Dwight Chrisman (the “'553 patent”). The compression torque device includes a housing having a first opening that accommodates a guidewire and a second opening; an actuator that passes through the second opening which is actuated by a finger in a direction substantially perpendicular to an axis of the guidewire; a clamp operably coupled to the actuator that compresses the guidewire to couple the guidewire to the housing when pressure is applied to the actuator; and a return spring that supplies pressure to remove the clamp from the guidewire. The compression torque device allows an interventionalist to reposition and manipulate the guidewire and the torque device with a single hand, without diverting attention away from the procedure image or the patient.